Credentialing Specialist Location: Pearland, TX, United States Job Description: Requisition number: 2350427 Job category: Network Management Primary location: Pearland, TX Overtime status: Non-exempt Travel: No Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. The Credentialing Specialist will be responsible for the credentialing and recredentialing of all employed Kelsey-Seybold physicians and contracted affiliated providers. The functions include but are not limited to initial and recredentialing applications, mailing and tracking of all applications, primary source verifications, file production and maintenance, presentation at Credentialing Committee, internal and external communication of outcome reporting, liaison with designated payors regarding the delegation of credentialing/recredentialing to Kelsey-Seybold (initial assessments, onsite audits, corrective action plans and submission of monthly reports), hospital privileges, assist with credentialing subdelegations and tracking of licensure/certification expirations You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High school diploma or equivalent - 2+ years of Credentialing experience with hospital application experience or managed care experience - Proficient: Microsoft Access, Word and Excel - Capable of sitting for extended periods of time Preferred Qualifications: - College Degree, Certification - Knowledge of AAAHC, NCQA and TDI credentialing standards, MD Staff - Academic Credentialing or Coordinator experience - Proven self starter who can work independently with minimal supervision Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

Title: Auto Claims Representative Locations: Duluth, GA Kennesaw, GA Albany, GA Macon, GA Newnan, GA time type Full time job requisition id R_5330 A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helping individuals and businesses make a new start when a loss occurs. Job Description We offer a merit-based work-from-home program based on job responsibilities. After initial training in-person, you could have the flexibility of work-from-home time as defined by the leadership team. Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated claims representative to join our team. This job handles entry-level insurance claims under close supervision through the life-cycle of a claim including but not limited to: investigation, evaluation, and claim resolution. This job provides service to agents, insureds, and others to ensure claims resolve accurately and timely. This job includes training and development completion of the Company’s claims training program for the assigned line of insurance and requires the person to: - Investigate, evaluate, and settle entry-level insurance claims - Study insurance policies, endorsements, and forms to develop foundational knowledge on Company insurance products - Learn and comply with Company claim handling procedures - Develop entry-level claim negotiation and settlement skills - Build skills to effectively serve the needs of agents, insureds, and others - Meet and communicate with claimants, legal counsel, and third-parties - Develop specialized skills including but not limited to, estimating and use of designated computer-based programs for loss adjustment - Study, obtain, and maintain an adjuster’s license(s), if required by statute within the timeline established by the Company or legal requirements Desired Skills & Experience - Bachelor’s degree or direct equivalent experience with property/casualty claims handling - Ability to organize data, multi-task and make decisions independently - Above average communication skills (written and verbal) - Ability to write reports and compose correspondence - Ability to resolve complex issues - Ability to maintain confidentially and data security - Ability to effectively deal with a diverse group individuals - Ability to accurately deal with mathematical problems, including, geometry (area and volume) and financial areas (such as accuracy in sums, unit costs, and the capacity to read and develop understanding of personal and business finance documents) - Ability to drive an automobile, possess a valid driver license, and maintain a driving record consistent with the Company’s underwriting guidelines for coverage - Continually develop product knowledge through participation in approved educational programs Benefits Auto-Owners offers a wide range of career opportunities, and we are seeking talent that will help us continue our long tradition of success. We offer a friendly work environment, structured training program, employee mentoring and an excellent compensation/benefits package. Along with a competitive base salary, matched 401(k), fully-funded pension plan (once vested), and bonus programs, Auto-Owners also provides generous paid time off including holidays, vacation days, personal time, and sick leave. If you're looking to do rewarding work alongside great people, Auto-Owners is the place for you! Equal Employment Opportunity Auto-Owners Insurance is an equal opportunity employer. The Company hires, transfers, and promotes on the basis of ability, without consideration of disability, age, sex, race, color, religion, height, weight, marital status, sexual orientation, gender identity or national origin, or any factor contrary to federal, state or local law. *Please note that the ability to work in the U.S. without current or future sponsorship is a requirement. #LI-DNP #LI-Hybrid #IN-DNI

Role Description The Claims Specialist is responsible for timely and accurate filing of all vision and medical claims for a vision care practice. This position requires working with insurance companies, creating and submitting insurance claims, processing insurance claims, and any necessary follow-up work for rejected claims. Additional responsibilities include: - Processing insurance claims and following up - Applying cash received to open invoices - Other billing departmental needs as assigned Qualifications - Good to excellent spelling, grammar and written communication skills - Knowledge and understanding of EOBs and HCFA forms - Ability to analyze and resolve unpaid claims issues - Knowledge of CPT and ICD codes - Excellent telephone and oral communication skills - Must have experience with electronic processing of medical and vision claims - Experience in Accounts Receivable (A/R) - 1-2 years of medical and vision claims experience preferred - Prior use of Practice Management and EHR Systems preferred Company Description Equal Opportunity Employer

• Support Claims teams by resolving complex system and process issues • Identify root causes and deliver timely solutions that improve daily operations • Collaborate with the Help Desk, IT, and business partners to enhance workflows • Contribute to system improvements and support testing and training efforts • Drive greater efficiency, reduce disruptions, and empower users to work more effectively and independently • Serve as subject matter expert for the Claims Help Desk on complex claims systems, administration, and technical issues • Triage and resolve escalated issues using diagnostics and root cause analysis • Deliver timely, accurate resolutions and recommend appropriate workarounds when needed • Partner with Help Desk and IT teams to support issue resolution and system improvements • Develop and maintain training materials, job aids, and procedural documentation • Collaborate with Claims Training to create resources and deliver user training • Act as liaison between Claims and IT to clarify business needs, outcomes, and impacts • Manage intake, escalation, and documentation in alignment with established standards and SOPs • Analyze and prioritize defects, bugs, and enhancement requests requiring long-term fixes • Ensure escalated issues are well-scoped, documented, validated, and tracked • Support system testing, enhancements, and identify improvement opportunities • Coordinate operational readiness activities like communications and adoption tracking • Partner with stakeholders to support non-technical project work and improve workflows/system usability